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Extent of central lymph node dissection for papillary thyroid carcinoma in the isthmus

PURPOSE: The incidence of papillary thyroid carcinoma (PTC) arising from the isthmus is low; however, these tumors have aggressive clinical and pathological features. Moreover, the existing guidelines regarding the extent of surgery for this type of tumor are unclear. METHODS: This study enrolled 28...

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Autores principales: Chang, Young Woo, Lee, Hye Yoon, Kim, Hwan Soo, Kim, Hoon Yub, Lee, Jae Bok, Son, Gil Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Surgical Society 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5931932/
https://www.ncbi.nlm.nih.gov/pubmed/29732353
http://dx.doi.org/10.4174/astr.2018.94.5.229
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author Chang, Young Woo
Lee, Hye Yoon
Kim, Hwan Soo
Kim, Hoon Yub
Lee, Jae Bok
Son, Gil Soo
author_facet Chang, Young Woo
Lee, Hye Yoon
Kim, Hwan Soo
Kim, Hoon Yub
Lee, Jae Bok
Son, Gil Soo
author_sort Chang, Young Woo
collection PubMed
description PURPOSE: The incidence of papillary thyroid carcinoma (PTC) arising from the isthmus is low; however, these tumors have aggressive clinical and pathological features. Moreover, the existing guidelines regarding the extent of surgery for this type of tumor are unclear. METHODS: This study enrolled 282 patients who underwent total thyroidectomy with bilateral central lymph node dissection. The patients were divided into 2 groups based on the location of the median line of the PTC. Group I included patients in whom the median line was located between the lateral margins of the trachea; group II included all others. We compared the 2 groups and conducted a multivariate analysis to assess risk factors for contralateral node metastasis from a PTC arising from the isthmus. RESULTS: Patients in group I had significantly higher frequencies of extrathyroidal extension and central lymph node metastasis. Group I also had a higher frequency of contralateral node metastasis, and a tumor size >1.0 cm was identified as an independent risk factor for contralateral node metastasis among patients in this group. CONCLUSION: Bilateral central lymph node dissection could be considered for patients with isthmic PTCs >1.0 cm in size who have clinically suspicious node metastasis.
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spelling pubmed-59319322018-05-05 Extent of central lymph node dissection for papillary thyroid carcinoma in the isthmus Chang, Young Woo Lee, Hye Yoon Kim, Hwan Soo Kim, Hoon Yub Lee, Jae Bok Son, Gil Soo Ann Surg Treat Res Original Article PURPOSE: The incidence of papillary thyroid carcinoma (PTC) arising from the isthmus is low; however, these tumors have aggressive clinical and pathological features. Moreover, the existing guidelines regarding the extent of surgery for this type of tumor are unclear. METHODS: This study enrolled 282 patients who underwent total thyroidectomy with bilateral central lymph node dissection. The patients were divided into 2 groups based on the location of the median line of the PTC. Group I included patients in whom the median line was located between the lateral margins of the trachea; group II included all others. We compared the 2 groups and conducted a multivariate analysis to assess risk factors for contralateral node metastasis from a PTC arising from the isthmus. RESULTS: Patients in group I had significantly higher frequencies of extrathyroidal extension and central lymph node metastasis. Group I also had a higher frequency of contralateral node metastasis, and a tumor size >1.0 cm was identified as an independent risk factor for contralateral node metastasis among patients in this group. CONCLUSION: Bilateral central lymph node dissection could be considered for patients with isthmic PTCs >1.0 cm in size who have clinically suspicious node metastasis. The Korean Surgical Society 2018-05 2018-04-30 /pmc/articles/PMC5931932/ /pubmed/29732353 http://dx.doi.org/10.4174/astr.2018.94.5.229 Text en Copyright © 2018, the Korean Surgical Society http://creativecommons.org/licenses/by-nc/4.0/ Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Chang, Young Woo
Lee, Hye Yoon
Kim, Hwan Soo
Kim, Hoon Yub
Lee, Jae Bok
Son, Gil Soo
Extent of central lymph node dissection for papillary thyroid carcinoma in the isthmus
title Extent of central lymph node dissection for papillary thyroid carcinoma in the isthmus
title_full Extent of central lymph node dissection for papillary thyroid carcinoma in the isthmus
title_fullStr Extent of central lymph node dissection for papillary thyroid carcinoma in the isthmus
title_full_unstemmed Extent of central lymph node dissection for papillary thyroid carcinoma in the isthmus
title_short Extent of central lymph node dissection for papillary thyroid carcinoma in the isthmus
title_sort extent of central lymph node dissection for papillary thyroid carcinoma in the isthmus
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5931932/
https://www.ncbi.nlm.nih.gov/pubmed/29732353
http://dx.doi.org/10.4174/astr.2018.94.5.229
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